A study published in early December 2015 in the American Journal of Cardiology shows an association between long-term statin use and an increased risk of kidney disease.
The study, an eight-year retrospective study with a median 6.4-year follow-up, compared statin users with controls who did not take statins. The statin users showed a 30 percent to 36 percent greater prevalence of kidney disease during follow-up averaging 4.5 years, Medscape reports.
Statins lower the risk of cardiovascular disease and cardiovascular death, but “statins increase the risk of incident diabetes and possibly kidney diseases, both of which paradoxically increase long-term morbidity and mortality,” the researchers explain.
For their study, the researchers analyzed health care data from 2003 to 2012 for 30- to 85-year-olds in the San Antonio, Texas area who were members of Tricare Prime or Tricare Plus insurance plan for members of the military and their families. All patients were continuously enrolled in the health care plan during the study, and there were no missing data, according to Medscape. The study’s lead author is Dr. Tushar Acharya (University of California, San Francisco).
Over all, statin use was associated with a significantly increased risk of different types of kidney disease. In the healthy cohort, patients who received statins had a significantly higher risk of chronic kidney disease (odds ratio 1.53; 95% CI 1.27–1.85, P<0.001). After adjustment for diseases (such as hypertension) that developed during follow-up, this association weakened, suggesting that these factors are implicated in the development of kidney disease.
The cohort consisted of 43,438 individuals: 13,626 statin users and 29,812 nonusers. The most commonly prescribed statin was simvastatin (Zocor), 73.5 percent; then atorvastatin (Lipitor), 17.4 percent; pravastatin (Pravachol), 7 percent; and rosuvastatin (Crestor), 1.7 percent. Thirty-eight percent of the statin users took high-intensity doses and they took the drugs for a mean of 4.65 years, Medscape reports. The researchers matched 6,342 statin users with 6,342 nonusers, according to the individuals’ baseline demographics, comorbidities, presence of kidney disease, and their health care and medication use. In the matched cohort, patients had a mean age of 56, and 45 percent were women. The “healthy cohort” consisted of 3,982 statin users and 21,988 nonusers. The researchers matched 3,351 statin users with 3,351 nonusers. All of these individuals were free of diabetes, chronic kidney disease, cardiovascular disease, and conditions that might limit life expectancy or physical activity.
Senior author, Dr. Ishak A. Mansi of the University of Texas Southwestern, Dallas, said individuals who take statins should not stop taking them based on this study, but health care providers should monitor their creatinine levels. (Creatinine is an indicator of kidney health.) Dr. Mansi explained that although statins have been in use for more than a quarter of a century, “there are aspects about its long-term effects in noncardiac diseases that we do not know very well.” New guidelines from the American College of Cardiology will increase statin use to hundreds of millions more healthy people, and so “we better make sure that we are not causing harm,” Dr. Mansi cautioned.
The researchers noted that randomized controlled trials for statins were sometimes terminated once the efficacy of reducing major acute cardiovascular events was achieved, and these trials rarely had total mortality as a primary outcome. They point to the urgent need for further studies “in which the long-term effects of statins on total mortality and total comorbidity indices (not only cardiovascular morbidity) are set as the primary outcomes,” according to Medscape.
from Parker Waichman http://www.yourlawyer.com/blog/study-shows-incidence-of-kidney-disease-higher-in-long-term-statin-users/
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